Violence against nurses by patients and visitors in the emergency department: An integrative review.

AIM: This integrative review explored violence against emergency nurses by patients/visitors, examining its nature, contributing factors and consequences. DESIGN: Integrative review. DATA SOURCES: Articles were obtained from PubMed, CINAHL, EMBASE, Web of Science and PsycInfo databases, up until December 2021. REVIEW METHODS: 26 articles were reviewed, evaluating study quality with the Crowe Critical Appraisal Tool and synthesizing conclusions through theme development and coding. RESULTS: This review delves into the issue of violence perpetrated against emergency nurses by patients and visitors. It elucidates three overarching themes: the nature of violence, the contributing factors and the consequences of such acts. CONCLUSION: The findings inform healthcare policy for the development of prevention approaches while identifying research gaps and emphasizing the need for alternative study designs and methodologies. IMPACT: This review has implications for nursing practice, policymaking and research, emphasizing the need for stakeholder engagement and tailored interventions for at-risk emergency nurses. NO PATIENT OR PUBLIC CONTRIBUTION: This project was an integrative review of the literature therefore no patient or public contribution was necessary. WHAT ALREADY IS KNOWN: Violence by patients and visitors in healthcare settings, especially in emergency departments, has garnered considerable attention. WHAT THIS PAPER ADDS: This review specifically examines violence-targeting emergency department nurses from patients and visitors, assessing its characteristics, contributing factors and consequences. IMPLICATIONS FOR PRACTICE/POLICY: The findings will guide stakeholder engagement in developing interventions to support vulnerable emergency nurses.

Violence against nurses by patients and visitors in the emergency department: A concept analysis.

AIM: This analysis investigates the concept of violence against nurses by patients and visitors in the emergency department. It aims to differentiate, clarify, and clearly identify this specific concept, which will facilitate more apt measurement and reporting, ultimately to contribute violence reduction measures. BACKGROUND: Due to contextual factors, occupational risk and patient characteristics, violence against nurses by patients and visitors in the emergency department varies from other types of violence against other health care staff. METHODS: This study employed Walker and Avant's concept analysis technique. RESULTS: The analysis found that violence against nurses by patients and visitors in the emergency department is primarily an occurrence of interpersonal violence based on the working relationship, whereby the patient and/or visitor becomes an assailant, and a nurse becomes a target in the absence of capable guardianship. There is also an intentional use of physical force or power, which results in or has a high chance of causing harm. CONCLUSION: A clearer understanding of the antecedents, attributes, and consequences of violence against nurses by patients and visitors arising from this concept analysis provides a framework that will assist in the understanding, measurement, reporting, and prevention of violence and inform future research. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers are encouraged to adopt strategies that act on the factors related to attributes and antecedents that will serve to reduce the occurrence of intentional violent acts.

Relationships between social capital, patient empowerment, and self-management of patients undergoing hemodialysis: a cross-sectional study.

BACKGROUND: Hemodialysis is the most common treatment of end-stage renal disease. However, it is associated with a range of symptoms affecting patients' daily activities and quality of life. Effective self-management has proven crucial for the alleviation of symptoms. According to Social Cognitive Theory, social capital and patient empowerment may be important variables for predicting self-management. To date, few studies have explored the mechanisms underlying these results. The study aimed to verify whether patient empowerment mediated the effect of social capital on the self-management of hemodialysis patients. METHODS: The study was performed with 245 hemodialysis patients from January 2021 to April 2021 in Taiyuan, China. Demographic and clinical characteristics, social capital, patient empowerment, and self-management of patients undergoing hemodialysis were measured with a self-reported questionnaire. Descriptive statistics were used to summarize the participants' demographic and clinical characteristics, and bootstrapping tests were used to verify whether patient empowerment mediated the association of social capital with self-management in patients undergoing hemodialysis. RESULTS: Mediation analysis indicated that social capital and patient empowerment significantly predicted self-management. Patient empowerment partially mediated the relationship between social capital and self-management in hemodialysis patients. CONCLUSIONS: The results suggest that hemodialysis patients show relatively poor self-management and that patient empowerment mediates both social capital and self-management. Strategies to mobilize patients' social networks and help them identify and utilize effective social resources may provide useful information regarding the implementation of optimal health management for their disease.

A Dual Attention Encoding Network Using Gradient Profile Loss for Oil Spill Detection Based on SAR Images.

Marine oil spills due to ship collisions or operational errors have caused tremendous damage to the marine environment. In order to better monitor the marine environment on a daily basis and reduce the damage and harm caused by oil pollution, we use marine image information acquired by synthetic aperture radar (SAR) and combine it with image segmentation techniques in deep learning to monitor oil spills. However, it is a significant challenge to accurately distinguish oil spill areas in original SAR images, which are characterized by high noise, blurred boundaries, and uneven intensity. Hence, we propose a dual attention encoding network (DAENet) using an encoder-decoder U-shaped architecture for identifying oil spill areas. In the encoding phase, we use the dual attention module to adaptively integrate local features with their global dependencies, thus improving the fusion feature maps of different scales. Moreover, a gradient profile (GP) loss function is used to improve the recognition accuracy of the oil spill areas' boundary lines in the DAENet. We used the Deep-SAR oil spill (SOS) dataset with manual annotation for training, testing, and evaluation of the network, and we established a dataset containing original data from GaoFen-3 for network testing and performance evaluation. The results show that DAENet has the highest mIoU of 86.1% and the highest F1-score of 90.2% in the SOS dataset, and it has the highest mIoU of 92.3% and the highest F1-score of 95.1% in the GaoFen-3 dataset. The method proposed in this paper not only improves the detection and identification accuracy of the original SOS dataset, but also provides a more feasible and effective method for marine oil spill monitoring.

The Real Experience and Management Strategies Analysis of Chinese Nurses Aiding COVID-19 Epidemic: A Qualitative Study.

OBJECTIVE: Emergent public health events, such as coronavirus disease 2019 (COVID-19), have been the focus of attention of researchers at home and abroad. In China, nurses are an important group contributing to the prevention and control of the COVID-19 pneumonia epidemic. METHODS: Using semi-structured interviews, qualitative interviews were conducted with 23 nurses who supported the novel coronavirus pneumonia epidemic, and the data were collated and analyzed using Colaizzi analysis. RESULTS: The work experience of Chinese nurses can be summarized into 4 major themes: they had different emotional experiences during aiding periods, aiding work had a double impact on the nurses, there were certain difficulties in aiding work, and there were significant age differences in aiding work experience. CONCLUSIONS: It is necessary to strengthen the psychological construction of nurses. All hospitals must coordinate and manage various safety tasks, and ensure the precise, scientific, and streamlined deployment of rescue work. Humanized management, shift adjustment, performance allocation weight, and organizational care are also the top priorities of human resource management.

A cross-sectional exploration of emergency department nurses' moral distress, ethical climate and nursing practice environment.

INTRODUCTION: Moral distress is a common phenomenon among nurses that leads to physical and emotional problems and affects job retention, job satisfaction, and quality of care. AIM: To explore relationships between moral distress, ethical climate, and nursing practice environment among a sample of ED nurses and determined significant predictors of moral distress in organizational environments. METHODS: A cross-sectional descriptive and correlational survey was performed on 237 nurses in emergency departments (EDs) from five hospitals in Taiyuan, mainland China. RESULTS: Statistically significant negative and moderate correlations were found between the level of moral distress and ethical climate for the overall evaluation and 10 subscale scores and the overall evaluation of the nursing practice environment. The nurse-physician collaboration, ethical climate, and monthly income were statistically significant predictors of the level of moral distress (change in R2 = 17.9%, 5.5%, and 5.6%, respectively). CONCLUSIONS: Perceptions of a more positive ethical climate and healthier nursing practice environment resulted in lower moral distress levels experienced by ED nurses. Poor nurse-physician collaboration is a pivotal factor accounting for ED nurses' moral distress.

Manual lymphatic drainage for lymphedema in patients after breast cancer surgery: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Studies have shown that manual lymphatic drainage (MLD) has a beneficial effect on lymphedema related to breast cancer surgery. However, whether MLD reduces the risk of lymphedema is still debated. The purpose of this systematic review and meta-analysis was to summarize the current evidence to assess the effectiveness of MLD in preventing and treating lymphedema in patients after breast cancer surgery. METHODS: From inception to May 2019, PubMed, EMBASE, and Cochrane Library databases were systematically searched without language restriction. We included randomized controlled trials (RCTs) that compared the treatment and prevention effect of MLD with a control group on lymphedema in breast cancer patients. A random-effects model was used for all analyses. RESULTS: A total of 17 RCTs involving 1911 patients were included. A meta-analysis of 8 RCTs, including 338 patients, revealed that MLD did not significantly reduce lymphedema compared with the control group (standardized mean difference (SMD): -0.09, 95% confidence interval (CI): [-0.85 to 0.67]). Subgroup analysis was basically consistent with the main analysis according to the research region, the publication year, the sample size, the type of surgery, the statistical analysis method, the mean age, and the intervention time. However, we found that MLD could significantly reduce lymphedema in patients under the age of 60 years (SMD: -1.77, 95% CI: [-2.23 to -1.31]) and an intervention time of 1 month (SMD: -1.77, 95% CI: [-2.23 to -1.30]). Meanwhile, 4 RCTs including, 1364 patients, revealed that MLD could not significantly prevent the risk of lymphedema (risk ratio (RR): 0.61, 95% CI: [0.29-1.26]) for patients having breast cancer surgery. CONCLUSIONS: Overall, this meta-analysis of 12 RCTs showed that MLD cannot significantly reduce or prevent lymphedema in patients after breast cancer surgery. However, well-designed RCTs with a larger sample size are required, especially in patients under the age of 60 years or an intervention time of 1 month.

The mediating and moderating roles of resilience in the relationship between anxiety, depression, and post-traumatic growth among breast cancer patients based on structural equation modeling: An observational study.

This study aimed to analyze the moderation and moderation effects of resilience on the anxiety, depression impact on post-traumatic growth (PTG) among breast cancer patients undergoing chemotherapy based on structural equation modeling, and confirmed whether resilience was a mediating and regulating variable between anxiety, depression, and post-traumatic growth. In addition, whether anxiety and depression have different effects on PTG under different levels of psychological resilience.This cross-sectional study was conducted from November 2017 to January 2019, with subjects of 260 breast cancer patients undergoing chemotherapy in the department of breast and general surgery of a tertiary general hospital in Shanxi Province of China.Data were collected according to the General Hospital Anxiety and Depression Scale, Connor-Davidson Resilience Scale, and the posttraumatic growth inventory. Estimated values of model path coefficients and significance test were performed to confirm the mediation effect. Hierarchical regression and simple slope test were used to analyze the regulation effect.Resilience showed significant correlations with anxiety, depression and PTG (all P < .01). Estimated values of model path coefficients and significance test results indicated that the mediating role of resilience was remarkable and it could regulate anxiety, depression, and PTG.The anxiety, depression and resilience affected their PTG of breast cancer patients during chemotherapy, suggesting the need to establish a cooperative mechanism based on the concept of multidisciplinary collaboration. Professional psychological intervention should be used to reduce anxiety and depression and to explore the potential of resilience to promote their PTG.

Preparedness of Our Emergency Department During the Coronavirus Disease Outbreak from the Nurses' Perspectives: A Qualitative Research Study.

INTRODUCTION: This study explores the preparedness of our emergency department during the COVID-19 outbreak from the nurses' perspectives, providing a reference and basis for our emergency department's response to public health emergencies. METHODS: Using qualitative research methods, semistructured interviews were conducted with 12 emergency nurses who met the inclusion criteria, and Colaizzi analysis was used for data analysis, summary, and induction. RESULTS: A cluster of 4 themes that involved preparedness of the emergency department during the COVID-19 outbreak was extracted: organizational preparedness, personal preparedness, patient and family preparedness, and deficiencies and challenges. DISCUSSION: Organizations, individuals, patients, and family members were actively prepared to respond to novel coronavirus pneumonia outbreak in the emergency department. The emergency nurses said that the trusted organization guaranteed personal preparedness, and the active cooperation from patients and families was a motivator for personal preparedness. In addition, our study showed that there were deficiencies in both multidisciplinary collaboration efforts and efforts to rapidly diagnose and treat patients with fever in critical condition.

General phenomenon and communication experience of physician and nurse in night shift communication: A qualitative study.

AIM: This paper explored the general phenomenon and psychological experience of the special background communication in night shift medical staff and provides better reference for night shift communication between doctors and nurses. BACKGROUND: Physician-nurse communication has always been an important agenda for health care work and an important concept in nursing theory. During night shifts, effective doctor and nurse communication can enhance mutual trust, provide timely and appropriate medical services to patients, reduce adverse events and enhance patient safety. DESIGN: A qualitative study was conducted. METHODS: Husserl's descriptive phenomenology method and semi-structured in-depth interviews were used to collect data from 8 nurses and 5 doctors. Colaizzi's method was used to analyse data using MAXQDA 12. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed (see Appendix S1). RESULTS: Three themes were extracted after sorting out and refining: the need to achieve goals in night-time physician-nurse communication; obstacles in night-time physician-nurse communication; and relationship culture in night-time physician-nurse communication. CONCLUSION: Attention should be paid to the particularity of night shift and efficiency of achieving the goal of communication between doctors and nurses on night shift, and the hidden obstacles behind communication between doctors and nurses. Managers should pay attention to the cultural construction of night shift communication in the system, form a good night shift communication process and regularly train doctors' and nurses' related communication skills. And they should also study relationship culture rationally to improve the communication efficiency of night shift. IMPLICATIONS FOR NURSING MANAGEMENT: The experiences described in this study contribute to a better understanding of obstacles hidden behind night shift physician-nurse communication. This also provides valuable information to professional managers who develop good doctor-nurse relationship culture.

Effects of polycyclic aromatic hydrocarbons on the UV-induced fluorescence spectra of crude oil films on the sea surface.

As the main fluorescent substances in oils, polycyclic aromatic hydrocarbons (PAHs) are the basis of ultraviolet (UV)-induced fluorescence spectroscopy methods to detect oil films on the sea surface. The relative contents of PAHs in six crude oil samples and their effects on ultraviolet fluorescence spectra were studied. The PAHs were divided into four categories according to their fluorescence characteristics. Naphthalene series dominated the fluorescence spectra, which led to a main peak at 320-350 nm, but this showed no relationship with PAH content. The six oil samples could not be distinguished by differences in the fluorescence spectra in this range, but could be distinguished by the fluorescence spectra in the 350-380 nm band. The relative contents of dibenzothiophene and phenanthrene series showed significant positive correlations (R2 = 0.96) with fluorescence intensity. Fluorescence spectroscopy combined with GC-MS can be used to distinguish and identify crude oils.

Effects of weathering process on the stable carbon isotope compositions of polycyclic aromatic hydrocarbons of fuel oils and crude oils.

Two fuel oils and two crude oils were subjected to a 60-day weathering simulation experiment, and the effects of weathering on some common parameters for aromatics and aromatic δ13C values were studied. The results show that weathering of all oil samples affected little the DBT/P (dibenzothiophene/phenanthrene) ratio and methylphenanthrene distribution fraction. Four oil samples could be distinguished only by the DBT/P ratio. The effect of weathering on isotopes in polycyclic aromatic hydrocarbons was small. The results show that the types of four oil samples can be distinguished, while Kuwait and Russia crude oils cannot be discriminated from each other totally by double-coordinate two-dimensional maps for aromatic δ13C; all of the oil samples can be distinguished by principal component analysis of δ13C for aromatics, the relationship of DBT/P and PAHs δ13C values. Therefore, the δ13C value of aromatics can be used as an alternative index for the analysis of oil spills.

Design and Implementation of a Coastal-Mounted Sensor for Oil Film Detection on Seawater.

The routine surveillance of oil spills in major ports is important. However, existing techniques and sensors are unable to trace oil and micron-thin oil films on the surface of seawater. Therefore, we designed and studied a coastal-mounted sensor, using ultraviolet-induced fluorescence and fluorescence-filter systems (FFSs), to monitor oil spills and overcome the disadvantages of traditional surveillance systems. Using seawater from the port of Lingshui (Yellow Sea, China) and six oil samples of different types, we found that diesel oil's relative fluorescence intensity (RFI) was significantly higher than those of heavy fuel and crude oils in the 180-300 nm range-in the 300-400 nm range, the RFI value of diesel is far lower. The heavy fuel and crude oils exhibited an opposite trend in their fluorescence spectra. A photomultiplier tube, employed as the fluorescence detection unit, efficiently monitored different oils on seawater in field experiments. On-site tests indicated that this sensor system could be used as a coastal-mounted early-warning detection system for oil spills.

Detection and Monitoring of Oil Spills Using Moderate/High-Resolution Remote Sensing Images.

Current marine oil spill detection and monitoring methods using high-resolution remote sensing imagery are quite limited. This study presented a new bottom-up and top-down visual saliency model. We used Landsat 8, GF-1, MAMS, HJ-1 oil spill imagery as dataset. A simplified, graph-based visual saliency model was used to extract bottom-up saliency. It could identify the regions with high visual saliency object in the ocean. A spectral similarity match model was used to obtain top-down saliency. It could distinguish oil regions and exclude the other salient interference by spectrums. The regions of interest containing oil spills were integrated using these complementary saliency detection steps. Then, the genetic neural network was used to complete the image classification. These steps increased the speed of analysis. For the test dataset, the average running time of the entire process to detect regions of interest was 204.56 s. During image segmentation, the oil spill was extracted using a genetic neural network. The classification results showed that the method had a low false-alarm rate (high accuracy of 91.42%) and was able to increase the speed of the detection process (fast runtime of 19.88 s). The test image dataset was composed of different types of features over large areas in complicated imaging conditions. The proposed model was proved to be robust in complex sea conditions.

Workspace Analysis and Optimization of 3-PUU Parallel Mechanism in Medicine Base on Genetic Algorithm.

A novel 3-PUU parallel robot was put forward, on which kinematic analysis was conducted to obtain its inverse kinematics solution, and on this basis, the limitations of the sliding pair and the Hooke joint on the workspace were analyzed. Moreover, the workspace was solved through the three dimensional limit search method, and then optimization analysis was performed on the workspace of this parallel robot, which laid the foundations for the configuration design and further analysis of the parallel mechanism, with the result indicated that this type of robot was equipped with promising application prospect. In addition that, the workspace after optimization can meet more requirements of patients.

Synthesis and Functions of Ag2S Nanostructures.

The paper presents a review about synthesis and applications of Ag2S nanostructures. As the modern photoelectric and biological materials, Ag2S nanomaterials are potentially useful for both structure and function purposes. Ag2S is a direction narrow band gap semiconductor with special properties. Ag2S nanostructures have been widely researched in chemistry and biochemistry fields because of their unusual optical, electrical, and mechanical properties. It can also be used in many fields, such as photovoltaic cells and infrared detector. In the past few years, Ag2S nanostructures have been synthesized by various methods. The article mainly discusses the four types of preparation methods. Moreover, this article shows a detailed review on the new properties, fabrication, and applications of Ag2S nanocrystals.